Radical antegrade modular pancreatosplenectomy (RAMPS) versus conventional distal pancreatectomy for left-sided pancreatic cancer: findings of a multicenter, retrospective, propensity score matching study

AbstractPurposeRadical antegrade modular pancreatosplenectomy (RAMPS) has been reported to achieve high rates of a negative margin and resected metastatic lymph nodes. However, many studies have used historical controls and the results remain controversial. We conducted this study to compare the surgical and long-term outcomes of RAMPS vs. conventional distal pancreatectomy (DP).MethodsThe subjects of this multicenter retrospective study were 106 patients who underwent curative resection for left-sided pancreatic cancer between 2012 and 2017. Overall survival (OS) and recurrence-free survival (RFS) rates were compared using Kaplan –Meier estimates.ResultsThe RAMPS group had more advanced T (T3/T4) and N stages (N1/N2) and a larger tumor size than the conventional group (T stage,p = 0.04; N stage,p = 0.02; tumor size,p = 0.04). The RAMPS group had more harvested metastatic lymph nodes (p = 0.02). After propensity-score matching, 37 patients from each group were included in the final analysis. There was no significant difference in RFS (p = 0.463) or OS (p = 0.383) between the groups. Multivariate analyses revealed the completion of chemotherapy to be an independent factor for RFS and OS (bothp 
Source: Surgery Today - Category: Surgery Source Type: research

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ConclusionsAlthough not curative on its own, irreversible electroporation holds promise as a treatment option for patients with locally advanced pancreatic cancer to increase downsizing to curative surgery or increase quality of life. Cone-beam computed tomography navigation can improve irreversible electroporation by providing guidance during needle guidance. Image fusion with previous advanced imaging can improve lesion visualization and targeting, thereby improving the effectiveness of irreversible electroporation.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Neoplasma. 2021 Nov 25:210924N1360. doi: 10.4149/neo_2021_210924N1360. Online ahead of print.ABSTRACTPancreatic ductal adenocarcinoma (PDAC) is a highly aggressive type of malignancy with one of the worst prognoses amongst any type of cancer. Surgery is applicable only to the limited number of patients with locally resectable tumors and currently represents the only curative treatment option. Treatment with chemotherapy and radiotherapy can only extend patient survival. Despite advances in conventional therapies, the five-year survival of PDAC remained largely unchanged. New in vitro and in vivo models are therefore urgent...
Source: Neoplasma - Category: Cancer & Oncology Authors: Source Type: research
Ann Surg Oncol. 2021 Nov 22. doi: 10.1245/s10434-021-11076-w. Online ahead of print.NO ABSTRACTPMID:34811621 | DOI:10.1245/s10434-021-11076-w
Source: Ann Oncol - Category: Cancer & Oncology Authors: Source Type: research
Objective: To identify the survival benefit of different adjuvant approaches and factors influencing their efficacy after upfront resection of pancreatic ductal adenocarcinoma (PDAC). Summary Background Data: The optimal adjuvant approach for PDAC remains controversial. Methods: Patients from the National Cancer Database who underwent upfront PDAC resection from 2010 to 2014 were analyzed to determine clinical outcomes of different adjuvant treatment approaches, stratified according to pathologic characteristics. Factors associated with overall survival were identified with multivariable logistic regressi...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
ConclusionsThis outcome reveals that this combination can be effective in treating metastatic pancreatic cancer, especially in pancreatic cancer patients with SMAD4 and TSC2 mutations. This may help increase the use of this therapy in large-scale clinical research.
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Eur J Pharm Biopharm. 2021 Nov 18:S0939-6411(21)00278-2. doi: 10.1016/j.ejpb.2021.11.005. Online ahead of print.ABSTRACTChemotherapy is the recommended treatment for patients with advanced pancreatic ductal adenocarcinoma (PDAC). However, efficacy of traditional chemotherapy is not satisfactory due to the presence of a dense dysplastic tumor stroma which prevents drug accumulation in and deep penetration into tumors. To overcome these obstacles, we designed and synthesized peptide dendrimers as potentiators of conventional chemotherapy. The dendrimers markedly promoted free doxorubicin accumulation and penetration deeply i...
Source: European Journal of Pharmaceutics and Biopharmaceutics - Category: Drugs & Pharmacology Authors: Source Type: research
Bull Cancer. 2021 Nov 16:S0007-4551(21)00439-2. doi: 10.1016/j.bulcan.2021.09.015. Online ahead of print.ABSTRACTPARP inhibitors are effective in different types of tumors such as ovarian, breast, prostate and pancreatic cancer. Many studies are in progress and may lead to prescription evolution. PARP inhibitors prescription is almost reserved to patients with a constitutional BRCA mutation or a somatic BRCA alteration or a tumor with a deficiency in homologous recombination. Nowadays, the diagnosis of homologous recombination deficit, HRD, is possible with the prescription of a myChoice CDx (Myriad) test. PARP inhibitors ...
Source: Bulletin du Cancer - Category: Cancer & Oncology Authors: Source Type: research
CONCLUSION: These data support the investigation of PDOs to guide treatment in prospective interventional trials in PDAC.PMID:34789479 | DOI:10.1158/1078-0432.CCR-20-4116
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Source Type: research
World J Gastroenterol. 2021 Oct 28;27(40):6775-6793. doi: 10.3748/wjg.v27.i40.6775.ABSTRACTPancreatic ductal adenocarcinoma (PDAC) is an aggressive tumor with high lethality. Even with surgery, radiotherapy, chemotherapy, and other locoregional or systemic therapies, the survival rates for PDAC are low and have not significantly changed in the past decades. The special characteristics of the PDAC's microenvironment and its complex immune escape mechanism need to be considered when designing novel therapeutic approaches in this disease. PDAC is characterized by chronic inflammation with a high rate of tumor-associated macro...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Source Type: research
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